Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,609.27 / $1,609.27 / $1,609.27	Facility		$1,609.27	$1,609.27	$1,609.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,609.27 / $1,609.27 / $1,609.27	Professional		$1,609.27	$1,609.27	$1,609.27
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $1,609.27 / $1,609.27 / $2,896.69	Facility		$1,609.27	$1,609.27	$2,896.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $1,609.27 / $2,896.69	Facility		$80.00	$1,609.27	$2,896.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $85.00	Professional		$50.00	$60.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $1,609.27 / $1,609.27 / $2,896.69	Facility		$1,609.27	$1,609.27	$2,896.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $80.00	Facility		$65.00	$65.00	$80.00